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UK GP leaders to vote on linking contract funding to inflation

UK GP leaders to vote on linking contract funding to inflation

UK LMCs could demand that GP contracts ‘provide for an automatic uplift in funding to cover inflationary pressures’.

At the UK LMCs conference later this month, GPs will debate whether the contract should include such a mechanism, which would be similar to the state pension ‘triple lock’.

LMC leaders proposing the motion will express concerns with the ‘ongoing failure’ of governments to ‘adequately invest’ in GP services, suggesting that the current adjusted GP capitation payment system does not accurately account for demand and activity per patient. 

GPs will vote on whether to ‘condemn’ the governments’ approach to ‘investing in short-term piecemeal schemes’ rather than ‘long-term planning and investment’ into the GP workforce.

The motion proposes that an ‘automatic uplift’ within the GP contract covers pay recommendations from the Review Body on Doctors’ and Dentists’ Remuneration (DDRB), changes to the National Living Wage, and increases in practice running costs. 

The GP Committee for England has repeatedly raised the impact of inflation on GP practice finance, and for the 2024/25 GP contract it had asked the Government for a 8.7% core contract uplift to cover inflationary pressures.

GPCE chair Dr Katie Bramall-Stainer said they reached this figure to cover the historic gap between inflation and core funding – she pointed out that since 2019, CPI inflation increased by 21.2%, while core contract investment only increased by 12.5%.

In Wales, GP leaders have criticised the ‘failure’ of the Welsh Government to negotiate a GP contract last year, with the GPCW chair saying the recent agreement is ‘sub-inflationary’.

At the LMCs conference, BMA GP Committees in the four nations could also be asked to develop ‘viable alternatives’ to the GMS contract, including ‘actively supporting GP practices to work outside the NHS’.

One motion calls for GP contracts to be agreed ‘by negotiation’ and that impositions should only be made by the Government ‘at times of national emergency’. 

This comes after the recent imposition of the 2024/25 GP contract in England, which increased funding by 2.2% and was overwhelmingly rejected by GPs in a BMA referendum.

Pulse had also revealed that GP leaders were ‘profoundly concerned’ that the Government labelled discussions around the contract as a ‘consultation’ with various groups rather than a ‘negotiation’ with the BMA, which seemed to ‘dilute’ the union’s role. 

The motion to be debated later this month suggests that all UK governments have failed to fund GP practices sufficiently, and proposes giving GPCs the power to ‘use the threat of mass resignations’ as leverage to improve the offer. 

GP leaders will also debate whether practices should receive contractual payment for providing continuity of care, the inadequacy of specialist ADHD services, and tougher sanctions on abusive patients.

Last year, LMC leaders at the UK conference called for the ability to offer private services to their registered NHS patients in certain circumstances and ‘at their discretion’.

Highlight motions at the 2024 UK LMCs conference

That conference is deeply concerned about the ongoing failure by governments to adequately invest in general practice services, as highlighted by the Kings Fund Report of February 2024, and:
(i) calls for a recognition and public acknowledgement of the impact that this is having on our patients’ ability to access GP services
(ii) believes that the current system of adjusted GP capitation payments has failed to account for demand and activity per patient over the years
(iii) condemns the approach of investing into short-term piecemeal schemes, with complex funding systems, which has prevented long-term planning and investment into the general practice workforce
(iv) instructs the GPCs to determine what ‘reasonable provision’ means in terms of the funding we are given to deliver GMS
(v) demands that GP contracts provide for an automatic uplift in funding to cover inflationary pressures, along similar lines as the state pension “triple lock”, including but not limited to pay recommendations issued by DDRB and / or government, changes to the National Living Wage, and increases in practice running costs.

That conference wishes for our governments to offer GMS contracts that have been agreed by negotiation and:
(i) demands that a GMS contract amendment can only be imposed on general practice at time of national emergency and not when negotiations prove difficult
(ii) believes that UK governments have failed to provide the necessary investment to ensure the survival of GMS
(iii) believes that being prepared to walk away may be more effective than industrial action
(iv) mandates the GPCs to develop viable alternatives to GMS, including actively supporting GP practices to work outside the NHS
(v) empowers the GPCs to use the threat of mass resignation to improve the NHS offer to practices.

That conference believes in the value of appropriate continuity of care and calls on GPC UK and RCGP to collaborate on tools for measuring continuity and develop possible contractual solutions that provides payments to general practice teams for work that supports continuity of care for each devolved nation to debate and adopt if appropriate.

That conference is appalled at the lack of adequate ADHD and other neurodiversity services across the NHS, with demand for services continuing to rise sharply, impacting on GP workload. We call upon on the GPCs to work with and lobby relevant stakeholders to:
(i) fund and commission comprehensive local NHS ADHD and other neurodiversity services, delivered by appropriately trained and regulated clinicians, with the responsibility for initiating, monitoring, prescribing, and titrating any medications prescribed
(ii) ensure that no GP is expected to take over responsibility of ADHD medication prescribing or monitoring without a shared care agreement and appropriate funding to facilitate any required monitoring
(iii) provide support to GPs who do not feel comfortable facilitating shared care agreements for prescribing ADHD medications following an assessment that they do not feel has been conducted to a suitable standard
(iv) produce clear patient resources to explain NHS ADHD services and the role of GPs in ongoing prescribing, where felt appropriate, under shared care agreements
(v) allow patients to self-refer to NHS ADHD and other neurodiversity services, without the requirement to consult their GP.

That conference believes general practitioners working in urgent care or out of hours settings should, when adequately funded by commissioners, be engaged on terms which:
(i) include paid time for handling any complaints, significant event analyses, inquests and service-specific mandatory training
(ii) honour the pay awards recommended by the DDRB, with appropriate backdating when needed
(iii) allow income to be superannuated in the NHS pension scheme without reduction in the gross rate of pay
(iv) provide holiday entitlement when engaged as a worker or employee in keeping with other NHS employees rather than the statutory legal minimum

That conference recognises the increasing incidence of aggressive, threatening and violent incidents occurring in general practice and:
(i) demands that the criteria for inclusion in violent patient schemes should be relaxed
(ii) calls on all UK governments to ensure that the funding for violent patient schemes is uplifted to provide appropriate resource
(iii) mandates GPC UK to lobby governments for more severe sanctions for perpetrators

That conference has significant concerns about visible reduction in the representation of GPs within the BMA over the last two years, including changes to procedures for electing representatives to the 2024 BMA Annual Representative Meeting, and:
(i) believes that with the exception of the GPCs, the BMA no longer adequately represents all GPs
(ii) calls upon the GPC UK to consider GP relevant motions passed at ARM, but not to enact them unless they are consistent with UK LMC conference policy
(iii) requires the GPCs to analyse the evolving political movements in other branches of practice so that they may be better understood, learned from and that GPs can be appropriately protected from any conflicts of interest
(iv) calls on GPC UK to explore options regarding improving and safeguarding GP representation within the BMA, to prevent decisions about general practice being made by a body in which GPs are a minority
(v) requires GPC UK, GPDF and NIGPDF to explore and, if viable, enact and fund GP trade union representation independent of the BMA, whilst retaining close links with secondary care colleagues.

Source: BMA



Please note, only GPs are permitted to add comments to articles

David Church 9 May, 2024 1:56 pm

Does anybody still believe in the CPI as an accurate indicator of inflation any more?
In our experience, over the last 4 years, the inflation rate has been about 24% per year, not 12%; and the only thing that keeps the rate down is probably the exceptionally sub-inflationery pay rises for public sector employed workers!
Car insurance was raised by more than 40% this year alone, despite no claims and a no-claims discount. Fuel prices and energy prices skyrocketed and are staying very high. Water rates are increasing incredibly strongly for a system with no investment in maintaining infrastructure, and increasing service delivery problems.
Scrap the CPI as it is clearly influenced by politicians.

Yes Man 9 May, 2024 2:51 pm

^ amen brother

G Raj 9 May, 2024 6:30 pm

Link my funding to just inflation would be a disaster. What if there is deflation??

What we need is some kind of triple lock, contract would rise based on need, inflation, population factors etc. whichever is the highest

Dr No 10 May, 2024 9:56 am

Hand back the NHS contracts and go private. Then market forces will find our true value/income. Give the Tories back their own medicine. I hope they all choke on it,